Insurance Credit Specialist - Remote
About The Position
The Insurance Credit Specialist must have the ability to review and analyze accounts and/or credit balance reports from insurance carriers and patients to include reviewing explanation of benefits, contacting insurance carriers for additional information, and communicating with insurance carriers to gather information. This position requires fundamental knowledge of how insurance companies pay accordingly to contracts, how to read and interrupt an insurance explanation of benefits (EOB), and do precise follow-up with the insurance company via, phone, email, insurance web sites, etc. at an acceptable volume per day. A Specialist, Insurance Credit who excels in this role: Resolves both patient & insurance credit balance refunds. Research and resolve unapplied cash activity accounts. Documents any request or concern received via mail, e-mail, telephone, written correspondence, or in person on the patient’s account. Responsible for responding to insurance companies & patient requests for refunds in a timely manner (within 30 days of receipt in credit balance work list) Identifies the originating cause of the need for a refund and compiles a report of recurring issues to management. Responsible for correcting errors in the calculation and posting of insurance contractual adjustments. Maintains confidentiality of all protected health information (PHI) Performs all job functions in a manner consistent with MGRI expectations as defined in the mission statement and values. Adheres to policies and procedures as required by MGRI
Requirements
- Experience with analyzing explanation of benefits (EOBs) from various insurance companies/payers.
- One year of experience in insurance billing/insurance follow up for Medicare, Medicaid, commercial payers required.
- Medical terminology knowledge preferred.
- Knowledge of CPT / ICD-10 coding
Nice To Haves
- Associate degree or bachelor’s degree in healthcare administration or another related field preferred
Responsibilities
- Resolves both patient & insurance credit balance refunds.
- Research and resolve unapplied cash activity accounts.
- Documents any request or concern received via mail, e-mail, telephone, written correspondence, or in person on the patient’s account.
- Responsible for responding to insurance companies & patient requests for refunds in a timely manner (within 30 days of receipt in credit balance work list)
- Identifies the originating cause of the need for a refund and compiles a report of recurring issues to management.
- Responsible for correcting errors in the calculation and posting of insurance contractual adjustments.
- Maintains confidentiality of all protected health information (PHI)
- Performs all job functions in a manner consistent with MGRI expectations as defined in the mission statement and values.
- Adheres to policies and procedures as required by MGRI
Benefits
- Multiple levels of medical, dental and vision coverage for full-time and part-time employees.
- Life, accident, critical illness, hospital indemnity insurance, short- and long-term disability, paid family leave and paid time off.
- Higher education and certification tuition assistance, loan assistance and 401(k) retirement package and company match.
- Mental, physical, and financial wellness programs (free gym memberships, virtual care appointments, mental health services and discount programs).
- Ongoing learning and career advancement opportunities.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
